title: Emergency medical services versus private transport of trauma patients in the Sultanate of Oman: a retrospective audit at the Sultan Qaboos University Hospital.
abstract: OBJECTIVE
  This study aims to assess the differences in the outcome of road traffic trauma patients between those transported by emergency medical services (EMS) and those privately transported to the Sultan Qaboos University Hospital in the Sultanate of Oman in 2011.
  
  
  METHODS
  This is a retrospective study of road traffic trauma patients admitted to the Sultan Qaboos University Hospital between January to December 2011. Data for all cases were retrieved from the emergency department database. The general linear multivariate regression analysis model was performed to test the differences in outcome. The analysis controlled for age, gender, ethnicity, weekend injury, time of injury, triage status, Injury Severity Score, existence of head injury, need for intensive care unit admission and need for surgical management.
  
  
  RESULTS
  There were 821 trauma cases in 2011. 66.7% were transported by EMS. Male patients represented 65.7% of the cases. There was no significant difference in the characteristics of EMS and non-EMS trauma patients. In terms of inhospital mortality, the relative ratio of inhospital mortality between EMS and non-EMS groups was 0.64 (0.36-1.13), and p value 0.13. There is no significant difference in all other secondary outcomes tested.
  
  
  CONCLUSIONS
  EMS transported trauma patients had a statistically non-significant 36% reduction in mortality compared with privately transported patients admitted to the Sultan Qaboos University Hospital in 2011. Further, research that incorporates prehospital factors such as crash to arrival of EMS services and transport time to definitive healthcare facility should be conducted to evaluate the effectiveness of such a system in trauma care. Since non-EMS transport is likely to continue, public first aid training is critical to reduce mortality and morbidity of road traffic trauma in Oman.
authors.affiliation: Preventive and Social Medicine, University of Otago, Dunedin School of Medicine, Dunedin, New Zealand.
authors.forename: Sultan
authors.initials: S
authors.lastname: Al-Shaqsi
authors.affiliation: Emergency Department, Khoula Hospital, Ministry of Health, Muscat, Sultanate of Oman.
authors.forename: Ammar
authors.initials: A
authors.lastname: Al-Kashmiri
authors.affiliation: Emergency Medicine Resident, Oman Medical Speciality Board, Muscat, Sultanate of Oman.
authors.forename: Hamood
authors.initials: H
authors.lastname: Al-Hajri
authors.affiliation: Department of Surgery, Sultan Qaboos University Hospital, Muscat, Sultanate of Oman.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Al-Harthy
mesh_terms: D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D000552:Ambulances; D054869:Clinical Audit; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D017052:Hospital Mortality; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000401:mortality; D015999:Multivariate Analysis; D009850:Oman / Q000453:epidemiology; D012189:Retrospective Studies; D014187:Transportation of Patients / Q000379:methods* / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Emergency Ambulance Systems; Paramedics, Effectiveness; Pre-Hospital; Prehospital Care; Trauma